Audiology, Daily Updates, Future Ear Radio, Hearing Healthcare, Podcasts

107 – Ali Vega, Au.D. – Private Practice Audiology, Serendipity, and Saying Yes

Hello and welcome back for another episode of the Future Ear Radio podcast!

For this week’s episode, I had the pleasure of speaking with Dr. Ali Vega, Owner of Complete Hearing & Balance.

In this episode, Ali and I discuss:

  • Her backstory, motivation for pursuing Audiology, and experience owning a private practice in the Pacific Northwest
  • Audiology’s transition from a master’s level degree to a doctoral level degree & Ali being in one of the first cohorts of doctoral-level Audiologists in 2001
  • Recognizing serendipitous occasions and being willing to say “yes” to risk taking
  • “Accidental” entrepreneurialism and the willingness to never stop learning
  • Figuring out what aspects of your business that you want to own (i.e. Ali’s love for Radio advertising), and outsourcing the rest to vetted partners
  • Ali’s experience scaling her practice from one location to three 

My favorite line from Ali during this convo was, “I’ve been hustlin’ in Olympia Washington.” That’s the perfect way to encapsulate this episode and Ali’s professional journey thus far. Hard work and an unstoppable drive to help more people.

-Thanks for Reading-


Dave Kemp  00:08

All right, everybody, and welcome to another episode of the Future Ear Radio podcast. I’m very excited for today’s chat with Dr. Ali Vega. Ali, thanks so much for being here. Tell us a little bit about who you are and what you do.

Ali Vega, Au.D.  00:21

Sure. Well, thanks for having me. I mean, what a huge honor to be invited to be on podcast, I feel super fancy. So, I am an audiologist first and foremost, but I am an entrepreneur by accident. And so I’m a private practice owner. I now have three clinics in Washington State. My first clinic opened 12 years ago in Olympia, Washington. And I opened a satellite office for a couple years, actually five years, I learned a lot of lessons, made a lot of mistakes, closed that office, had a little satellite office and an e and t office for a few years and of closing that office. And then this year, well in 2022, I was like, Okay, I’m ready. I survived COVID. I made in fear pandemic. industry is booming, so much opportunity. And I was like, Okay, I think it’s time and I swear to you, it’s time. It’s like, I cannot keep up with the demand that’s happening right now.

Dave Kemp  01:25

Okay, that well, we’re gonna get into all this. This is really interesting. To rewind a little bit. Let’s go back to your start. How did you end up in audiology?

Ali Vega, Au.D.  01:35

So I grew up in North Idaho. I grew up in Moscow, Idaho, okay. And, you know, my parents worked at the university there. I just desperately needed to get out of town. And I saw that I was going to be a high school counselor. That was like my dream. I wanted to help high school students find their way in life. I was feeling not lost necessarily myself, but just knew that there were so many things I wanted to do in the world. And they, I loved my high school counselor, because she was really helping me sort of figure out how to line up the rest of my life. Like, I want to do that for other people. But then I went to school. So I went to school at Western Washington University in Bellingham, Washington, and loved going to school there. I was in all the psychology classes, and there was like, 400 people in all of my lecture classes, and I started looking around going, dang how we all gonna get jobs. You know, man, it just like, it seemed like there was a lot of us that all wanted to do the same thing. Yeah, I was starting to rethink my path. But I knew I wanted to help people. And I liked medicine, but I for sure was never going to get my doctorate. Like that was a hard no, my dad had a PhD, I just thought that’s not really the way that I want to go. So anyways, my family, not my parents, because they were professors. But right, the rest of my family was in the nursing home business. And my grandparents, my aunts, and uncles, they own all own piercing home. So I had some weekend jobs, nighttime jobs, where I would go work front desk and get to hang out with people. And I see professionals coming in doing contract services and things and there was this audiologist that came in to one of our nursing homes, and she was working with brain injury patients and do its and speech stuff. That’s kind of cool. You know, she gets to really help these people with these severe problems. She’s specialist, but she doesn’t have to, like, do surgery. And so actually, Newsweek also had an article at that particular time of the top 10 professions of the decade. And so this was like 1996, probably, and audiology was number one. So it wasn’t landec. Yeah, it was number one. So I took a class in audiology, which was actually Communicative Disorders. And I fell in love, I was hooked. Like, I loved the Science, I loved the art, I love the ability to help people, especially people who had like a very specific problem and like learning how the whole hearing system has to like all these little tiny pieces to work perfectly for you to hear well. And if one thing goes wrong, it’s like, oh, this is this is the issue or whatever. But then there was also all these resolutions that were available, like all these tools to help fix that problem. And with every other audiologist story, you know, we were put into mostly speech classes, and we got like one or two audiology classes, and those are like, the ones that I waited to get every day is like, Oh, I got audiology coming up. And if two o’clock or you know, whatever. But I had to put up with speech for a while. And what I didn’t like about speech was that it just took so long to see progress and patience. And I really loved the satisfaction of helping and being able to not only diagnose the problem, but then saying, Do you know how it helped you? I know how to make your life better. Yeah. And that was what really got me with audiology was being able to help people with quick results. That’s meant Yeah, I mean, it’s it’s almost like an adrenaline rush. You know, when you’re like, these people like I’ve had this problem for 20 years and nobody knows how to help me. I’m like you got silver. So it just is really was really fun and I fell in love with it. And then of course, you know, then now I need to get a doctorate degree and it just, it didn’t even matter. It was like summer camp. It was not the doctorate that I thought was going to be so terrible to get. I just wanted to keep going to more school or school and so I graduated from Western with it, the Christos degree in it was actually Speech and Hearing Sciences, I think is what it was called. And took a year off to to work in a clinic, then audiology clinic because I wasn’t really sure about graduate school yet. And it was still the time where there was a master’s degree. So I got a job working with Chris quarters at the hearing speech and deaf the Center in Seattle, and she’d bless that woman. She took me under her wing, and she made me her audiology assistant before that was a thing. I was like, I swear to God, I was one of the first theology assistants. She was calling me into hearing aid fittings, and she was teaching me how to reach earmolds. And she had me coming into pediatric appointments and being her assist with little kids. I mean, I got to do cool stuff. Yeah. And it’s just, it was so much fun all the time. So then I wanted to go to graduate school. And that’s when the AUD was just being released. Well now on the West Coast, really, but it was sort of like, you know, you could still get a masters or you could get a doctorate out when surrounding it masters. You know, and so I looked at big schools, and I looked at college debt and looked at Towson, and I went out east. Oh my God, it was such a West Coast girl like I’m small town, I’m gonna go eat no live out here. So I was a little bit disappointed. But I applied to San Jose State. They had an ed program at the time, and I was really the only one on the West Coast. And I got waitlist. And so I was like, well, I’ll just try again next year. And then Utah State called me and they said, We got your name from San Jose State waitlist. And they they offered me they offered me a flow rate actually. Well, they were like, oh, gosh, if you take a chance on us, we’ll take a chance on you.

Dave Kemp  07:13

Because that was were you like in the first is the court cohort of their program. I was in the unagi. super interesting. One was like 2001 Nurse one,

Ali Vega, Au.D.  07:23

one. Yep. In fact, I think my third day of school was 911. Row. Gosh,

Dave Kemp  07:28

yeah. That will really anchor that period of time for you then.

Ali Vega, Au.D.  07:33

Oh, for sure. Yeah, I mean, I was in a new so I moved down to Logan, Utah, and let’s find a school. And there was I think it was like 20 of us that started. And by the time we graduated, we were three.

Dave Kemp  07:43

Wow, really, because it was

Ali Vega, Au.D.  07:47

our first year was a master’s program. And then we morphed into it in a unique program. And Utah State was developing their curriculum as we’re taking classes and you know, some people, they just figured out the system for us. And sometimes professors were like, Hey, this is really not your right path. And so, you know, in a class of three, I won all sorts of awards. I have like top researcher top finished.

Dave Kemp  08:10

Class of carry. That’s hilarious. Okay, that’s really interesting. So go on. So So where we’re

Ali Vega, Au.D.  08:18

at? Yeah, yeah. So I studied at Utah State. I had an excellent experience there, highly recommend that program. And then I knew I want to come back from to the northwest. And I wanted to go back to Bellingham Seattle area, it was really hard to find a job at that point in time, I ended up getting a residency at an e and t office in Olympia, Washington, and worked there. Did my residents did my residency for rotation. And they hired me on I stayed with them for about seven years. And I was doing really, really well. I mean, I was selling a lot of hearing aids, I was seeing really complicated patients, I was collaborating with the EMTs. But really, at the end of the day, they saw me as the girl who did hearing tests in the back.

Dave Kemp  09:12

Yeah. Let me ask you really quick before you keep going. What was that like in that era of the e and t audiologists relationship? It sounds like you’re kind of gonna get into this. But yeah, because it’s I think this is kind of what’s interesting about audiology is it is actually it’s pretty nascent in terms of the AUD program, the doctoral level degree. And so it’s like you were one of the first people that came out as like the new newly branded doctoral level audiologist, were they previously working with audiologists in a different capacity, like were things changing? What was that whole dynamic like? anted audiologist back then, at least in your experience?

Ali Vega, Au.D.  09:53

Yeah, from my experience, so, I mean, I was the first ad audiologist they’d ever worked with. Yeah. In really the I mean, in the Seattle area, there were not a lot of AEDs. In this was so this was 2004. And, you know, they had they had a preconceived relationship with audiologists, you come in, you do hearing tests, you sell hearing aids, and you basically keep your ideas to yourself. And as long as I did that, we got along pretty well. But that wasn’t really my training. And too, that’s not really my personality. I read it while I was seven years, I learned I learned how to play the game, but I was always pushing the envelope like, hey, what do you think about tinnitus treatment? They’re like, No. Okay, so what do you think about auditory processing doesn’t exist? Okay. So she, you know what it is like, there was all these things, and I kept trying to push the envelope. One day, I wear my white coat, and one of my one of the Auntie’s who are super close with, we got along really, really well. He laughed at me in my white coat, he goes up at your trade to look like me.

Dave Kemp  10:59

Well, I was like, oh, there’s a whole lot of that.

Ali Vega, Au.D.  11:02

There was a lot of that. They liked tweet, they respected me, they thought I was good. But I was not a doctor, in their eyes and all. Yeah. And so as I was there, I learned a lot. I mean, I would never, I never regret my experience there. Because we’ve learned so much, especially for this phase in my career, and constantly reflecting back to just how it made me feel, and what I want to do different from my own employees, how much my old relationships are, but you know, I am the Doctor and I tell my audiologist, and I’m like, You are the doctor, we are the doctors. And it’s really empowering. But it wasn’t that way, then yeah, I was pretty intimidated by surgeons and touch just had to just work through that. So I think that audiologist now have a much better situation because it’s changed a lot. But back then, um, it’s definitely the girl who did hearing

Dave Kemp  11:55

just in the past. Okay, so

Ali Vega, Au.D.  11:57

that’s, and that’s, and that’s, yeah, and that’s ultimately why I ended up leading so anyway, so I was there about for about seven years, I was doing great. When I was building the business. In fact, I made more my first year there than I did when I left because I had a great bonus structure, and I was killing it. And then the more money I made, they’re like, Okay, we’re gonna take away that we’re gonna take away that. And then I was on straight salary. By the time I left, it was the least amount of money I’ve ever made. Because he figured out that I was going to make a lot of money if I was given the opportunity just

Dave Kemp  12:30

kept raising. Yeah, it was like you were already capturing all the growth initially. So yeah, okay, this is really interesting. So, so what did you do when you have to after seven years of being there?

Ali Vega, Au.D.  12:42

So I actually went to a Starkey conference, because I was spitting on Starkey products at the time, and I was approached by them to open a private practice. And I literally, that’s why I say I’m an entrepreneur back six. I was like, what? Yeah, no, not me. No, you got the wrong girl. And they were like, No, we we see something in you that we think you could be really successful in private practice. We’ve got this private practice program called the ascent program. And it’s relatively new. I think they had like maybe six clinics or something at the time, they were all on the East Coast. We think that you’re a good fit for the program. We’d like to interview you and C and why don’t you think about us, I went home, I thought about Danny. Yeah, that can be a really good opportunity for me. But I knew nothing about this. I mean, I literally had one business class that was mediocre. I knew I didn’t know how to do anything. And I didn’t have any money. And I didn’t, I didn’t know the first thing about running a business. And so the ascent program made a lot of sense for me, because they that was all built in. So they had all those business skills. So I essentially the way it was set up is that I was an employee of the business the first year, and then I became the owner. And then there was a payout program. But so anyways, I signed up with them. And it opened my own private practice in 2011. And I remember days where it was just me and him we have a receptionist that was answering the phone, see a patient when I when my patient would check in I put the phone on night or

Dave Kemp  14:14

do not disturb

Ali Vega, Au.D.  14:17

your back into a hearing test to try to sell some hearing aids and anything even that I’d go check the voicemail. I mean, it was it was rough, but I loved it. I was having fun. And over time, I learned a lot about the business faction bought out like yours. I think I was in life, fifth year, fifth or sixth year and ended up buying out from Starkey out of the program just because I simply outgrew it. I kind of learned, learn how to do my marketing. I was learning how to do that. And I hired people to do my books like I didn’t need them anymore. It was a great program that helped me get my feet wet. But then I just took off I hit the ground running.

Dave Kemp  14:57

It’s um so the last time position I just had on the podcast I interviewed a young female audiologist, Rachel McGann fever. And that episode I haven’t released yet, but it’s going to be titled entrepreneurism and audiology because the whole time we talked about becoming an entrepreneur and I, you know, what we talked about was like this idea that it’s, it’s kind of an odd situation, because you’re the labor pool is doctors, you know, it’s like, people that are pre decision, preposition predispositioned, for like that line of work. But then, you know, you have this like, entrepreneurial side of the business, that if you want to really have full autonomy, and in own your own practice, and all that, you have to, like, have all of that wherewithal as well. So I’m curious, like, Did this come naturally to you? Was this really challenging? Like, what was that period? Like? It sounds like this was a great program for you to help usher along, you know, and get you help to give you skills and training and all that. But what what what do you remember about that period? In terms of how much of this did it just feel like it came natural to you?

Ali Vega, Au.D.  16:07

It came pretty naturally to me. I mean, it surprises me how natural it has felt. The parts that I didn’t do well, what I learned early on was hire, hire people to help you do the things that you can’t do. And I tried to do my own payroll for a while, I was really bad at that. So I just decided, okay, let’s budget for that. I’m, what I’m really good at is my marketing. And I’m getting involved in my community and connecting with people. And so I still keep those things to myself. But I hire out all like all the legal stuff, the billing, oh, my God, we try to do our own billing for a while that was a disaster. I know that I’m capable of energy. But when I really looked at what I’m good at, and what I enjoy it, that’s where I’m trying to spend my focus and not be the I would send my best recommendation, anybody who’s thinking about should they do it or not, is figure out you’re good or not, and spend your energy there because it did come naturally, except for some of those technical things. And it is worth every penny to pay somebody else to do it. But the program was great, because it gave me the opportunity to see like, Can I do that? And then there was a safety net for the safety of people by No, no, you’re not good at that. Let’s set a 10 Selfie out

Dave Kemp  17:21

what would so you said that you really like marketing and stuff like that, like what comes to mind with some of the things that were even the community outreach that you’ve done, either back then or even today? Like, what are the kinds of things that you really like in those areas?

Ali Vega, Au.D.  17:38

Well, I always, I always say that I’ve been hustlin and just a hustler if you didn’t hear it. But Ruslan, we’ve been hustling in Olympia, Washington, but I, I’ve always been so I got involved. So really early on, I got involved in a lot of networking groups, and started talking about my business. So I was like, there was some group called BNI, business, networking international or something. And it was kind of cheesy, but it really helped me understand how to talk about my business, and get other people to be excited about my business the way I am. So I started joining some of these groups, all these little networking groups, I’m spending a lot of my time it’s, I would schedule one day a week that I wasn’t seeing patients at all. And I was just going to all these networking groups every single week and talking about my business and telling people why I love it, and how exciting it is, and all the things that can happen. And people were fixated. I mean, audiology is so obscure, really, in health care, that people are just like, Whoa, how have we never known about this? And like, I know, right? Like, it’s so quick. So exuding my own passion for what I do, was getting other people excited. And then they were telling their friends. I also did radio, and I took a break for radio for a while because it is pretty expensive. But I’m back to radio now and I do my own. That’s what I do. I do my own ads, and I love it. And the radio station loves it. And I have great relationships with like, all the people who work at the radio station, and because they’re audio people anyways, they’re super excited about it. So but I feel like that’s repeated when patients hear my voice on the radio. Yeah, they get they feel like they get to know me. They’re not hearing this actor or they’re not hearing somebody who works the radio station, but they’re and I actually had a woman years ago, came in with her husband for an appointment. She said, as soon as I heard your voice on the radio, I knew you were our doctor and you are the person and because she she like I could tell that you care and you love what you do. And I knew you were the person we had to see. And people still at my kids thought I was famous because they would hear my commercials on the radio. And I’m like, yeah, like paid for that. But that’s fine.

Dave Kemp  19:38

You don’t need to tell them that.

Ali Vega, Au.D.  19:41

But people still I mean, they’re like, Oh my god. Dr. Vega. I hear you on the radio all the time. Like Yes. I see like radio is a great way but I volunteer a lot in the community. At first it was like doing hearing screenings and things like that, but mostly I feel like just going and doing anything in the community, and I’m not trying to sell, I’m not trying to push my business, but I’m representing myself and I represent flannel. And people, I met a guy the other day, and I was wearing my logo shirt. And he goes, Hey, I know you heard you on the radio, and I have my sister came and saw you. And it was like he had all these connections, just because I was out wearing my logo gear. And I was also I was doing some community, but I serve on the board. And I’m on the board at the Washington Center for Performing Arts, they have an assisted living, listening. And they have an infrared system. And yeah, and so I go in and I consult with them, and I help them I help educate their volunteers about using it and troubleshooting it and you know, things like that like, that don’t take a lot of expertise or time, but I’m there like designated audiologist, when they can call just things like that, where I’m just being seen, we go to a lot auctions, we do a lot of things, but just being seen in the community and being a part of it. People want to do business with people they like,

Dave Kemp  20:57

yeah, with the radio ads, when, like, how did you even get into that? Did you come up and just say, I think this would be an effective way to get to like us, like attract new customers? Or is there a story behind it?

Ali Vega, Au.D.  21:10

I think actually, I was approached, I think I think I got a cold call honestly. And my first thought was, my people can’t hear. So that’s kind of a stupid way to get retires. But at honestly, if you think about it, my target audience is women, aged 25 to 60. Because they are the decision makers of the family. I’m not speaking to my patient, I am speaking to the decision makers of that family that loves the Lord, the daughter, the wife, a loved one, somebody who’s like, you need that. I met Oh, he needs that or my kid needs that my dad needs that, you know, I need that women are the decision makers of families. And they’re listening to the radio. That’s interesting,

Dave Kemp  21:55

though, do you get even today? Like are most of the meetings scheduled by the wife, the daughter? Is that pretty common? Or is it like, that’s already taken place? And now, my wife said I should call you and schedule an appointment.

Ali Vega, Au.D.  22:09

I do hear that a lot. Or thing or I hear that a lot of like, my wife made me come today or, or people call in and say I’m making an appointment for my family member. It’s it’s pretty common. We I mean, most of our business is Doctor referrals. Yeah, but because we do a lot of insurance. But I would say that we hear that often that my my wife made me today.

Dave Kemp  22:32

How did you build inroads with the with the physicians that are sending you referrals? Was that all started part of this community outreach and all that? Or did you have any distinct, you know, plans of approaching them.

Ali Vega, Au.D.  22:48

Now, what’s funny is that I this is all by mistake, I’m telling you, it’s like it just happens. And I don’t know how I can’t pinpoint. But I know that I have worked really hard at some things that have never panned out. And then other things just fall in my lap. And I’m I have no idea why. But so this is sort of interesting. And stick with me. It’s not too much of a tangent. But so I got so I opened a practice in 2011. I had a one year old, and a four year old at the time, two little boys. I got divorced pretty quickly, when I opened my practice. My ex husband wasn’t too happy about my, my new my new clinic and all the attention that was going towards that and our relationship suffered because of it. So I ended up being a single mom with a brand new clinic. I have no idea what I’m doing. And either in either rebuild my life. And so I ended up buying we sold our house that we had together and buying a house right by my clinic, because there was a school right there. And I had to like shrink my geographic day down to like my kids needed something and I was at the office and to make sure cannot work. So I moved to this neighborhood, right by my office right by my kids school and it was outside. And there was it was like one of those cul de sac neighborhoods and there’s kids playing all the time, like 24/7 I don’t know if kids are outside for all this time. And so I was outside with my kids. And this. This woman walked up to me I’m new in the neighborhood. She said what do you do for a living? And I said I’m an audiologist. She goes Oh, that’s funny. My husband is an EMT. And I said poem that is kind of funny. Yeah. What are the and he works at the hospital that’s just right down the street and like so a couple days later we meet he’s, you know, he’s a surgeon, so he’s not real chatty. So I didn’t even really get to know him all that well. And then like a few weeks later, maybe a month or two later, he approaches me outside on the coldest sack. And he said, Hey, our audiologist just quit. Do you think that you’d want to be a contract audiologist with a hospital and like come into my office like, I don’t know, a day or two a week and do some hearing tests and if you ever identify people who need hearing aids like you could sell them, you could take them back to you better practice installing hearing aids but just run some pre and post audios for me. And I said,

Dave Kemp  25:04

yeah, yeah, sure. Sign me up.

Ali Vega, Au.D.  25:08

I will do that. Yes. When would you like me to move in. And so

Dave Kemp  25:11

that’s why I’m serendipitous suffering is like,

Ali Vega, Au.D.  25:15

there’s no amount of taking cookies to an office that makes that happen now. So I mean, that was just and it was just knowing people and just being out and being seen and being open, open to opportunity.

Dave Kemp  25:29

There was no you gotta, you got to put yourself out there in order to even get the chance that the random chance you’re gonna increase your odds of that random thing that you could never foresee happening in Russia. You know what I mean? You got to just like be out there. It’s like taking bets.

Ali Vega, Au.D.  25:45

I could, there could have been a million reasons why I could have said no, yeah, in that conversation. I could have said no, for a million reasons. But I just said, Yes, I don’t know how I’m gonna do this. But I’m gonna make this happen. We’re gonna do this. So I did it. I set up I went it he had a booth and equipment, everything. And so I’d go in there one day a week. And I there was a schedule, and I was just running audios all day long. Boom, boom, boom, boom, boom. And then I’m writing down people’s names. I could take information with me taking copies of audios, written up people’s names, following up, and then taking them to identify private practice to hearing aid fittings. And I was then now in his he’s a, he was a employee of the hospital, I am in the hospital referral system. And there was like 1500 doctors, so any doctor that types in sharing loss into that system, my name pops up, Dr. Vega, and I just start getting that doctor referrals from that hospital system.

Dave Kemp  26:42

That’s super interesting. So does that kind of when your practice started to take off? So you said you started it in 2011? Roughly, how long was it open until this point happened?

Ali Vega, Au.D.  26:50

So I was open probably a year and a half. So it was like 2013, I think is when I started doing that. And I would say that that’s when the whole new trajectory took off. Cool. And I was my business was increasing dramatically.

Dave Kemp  27:08

That’s awesome. Okay, so then you have that, what was that phase like? This is really fun, just chronically kind of you’re

Ali Vega, Au.D.  27:16

like, now I know is Croesus read the book? It’s crazy. So that’s what I tried to do my own belly. Okay, this was a really fun chapter. Okay, is for the record, do not recommend one star review. And billing, especially if your practice is growing. And you’re billing a lot of insurance. I mean, if you’re not doing a lot of insurance, you might be able to figure it out. But it’s an insane monster. So we were trying to do that, I was also trying to break my teeth on how to actually manage employees, because now I had to have people covering the private practice, I was bringing out all this information for billing. I wasn’t in the practice every day. And so when I wasn’t there, they were kind of doing their own saying. So it was it was rough, but it was busy. But I was like moving around. Because I’m still doing networking, I’m still taking a day to do networking. I’m in this satellite office, couple days a week, and I’m in my private practice a couple days a week. So that that was a really busy time. But I was learning a lot about those physician relationships and learning how you foster those. So I didn’t really have to work hard to get the referral, because that was just happening organically. But what I learned is that I had to send that test results quickly. And I had to speak their language. And that’s where I’d reflect back on my auntie days. I knew I had, like, when I write a professional report, I click into Okay, what do they actually want to know, they don’t want me to write a freaking essay, they want me to be very direct to the point, here’s what I found, here’s what I think it is, here’s what I think should happen here are the next

Dave Kemp  28:53

Shanshan like that. But that is another skill, if we aren’t going to be all operating under the sort of assumption that one of the best ways to acquire more patients are these, you know, physician referrals, then the quid pro quo then is like, you got to be able, like you said, to like, speak their language, like the reports that you write back. So that’s a really interesting aspect. I feel like that, to your point, working in the EMTs. Office, you sort of knew how these surgeons typically operate. Right? So was that? I mean, were you able to, like pretty quickly, you know, accommodate for that and that need or were you getting overwhelmed?

Ali Vega, Au.D.  29:35

No, well, I mean, I, of course, first started because I had, I had a practice management software system, and this was also like, 2013 That wasn’t really conducive to like templating like now I use counselear. There’s a shout out for counselor, I use them and they and I can template all these reports. So I can, you know, take some time in my thought process template, all these things out and then have them ready to go When I’ve got a certain referral source, just plug and play, plug it in. But at the beginning, I had a Word document and a working Word document. And it was like a two page thing because I wanted to be thorough, and I wanted them to know how much I knew. And I wanted them to be really impressed with all of my knowledge. And the thing was, not only was it time consuming for me, but they probably were just like scan, scan, scan scan to the end, they’re like looking for you know what to do next. Meanwhile, they’re like, What is this garbage? She signed up with white rate ratio, using all these really big words, why can’t you just cut to the chase, you know, so I had to get over myself a little bit and realize that if I just spoke their language, and I was just super, if I presented myself at their same level, and didn’t try to act, if I was trying to be better, I was trying to be fancy was trying to use all these words that have sent me that we were going to be able to be more of a partnership. And that’s exactly what happened. I am the Doctor, they are that we are on the same level playing field. And by presenting the information to them just the way they want it. They were like, Okay, I like I like this, she makes it easy for me, she makes it easy for my patients, I and then by sending the reports really quickly, again, because I’m getting referrals from doctors who don’t even actually know who I am totally. They’re their medical assistants, their referral coordinators, whomever are getting these reports by fax, or seeing my logo come in constantly, constantly. Even if a patient is self referred, because their insurance company doesn’t require it. They still Iost Oh, good. Any issue of primary care doctor, and I’m sending a report to the primary care doctor because I want them seeing my logo and for only stinkin day, because then when they’re like, where do we send people for Harry test, I don’t know, this complete hearing imbalance or it used to be a sent audiology, they keep sending us report dated parent tests, we should send it there and more. And just cultivating that just to have is top of mind. I wanted to be top of our hand all the time. And so I think that was really a critical component to maintaining those referrals because they couldn’t forget about me, I was in their face every day.

Dave Kemp  32:07

I love that. That’s hilarious. Okay, so. So then moving along. So you got your practice, it sounds like you just like really started to take off quickly. Then you had this buyout. So I’m assuming this was probably 2015 ish or something around? Yeah, yeah, it

Ali Vega, Au.D.  32:26

was probably around 2015 2016. So then I decide, all right, I’m not growing Assistant Program ascent was great for what it was, but it really it’s, it’s hearing aid sales. And that is, that’s the formula. That program is how many hearing aids you’re selling. And every time you buy equipment, it’s like, well, how many hearing instruct, to sell to justify that everything’s equated and hear me in sales. I was doing a lot of diagnostics because I had all these physician referrals coming through CIT and so not everything was a hearing aid sale because sometimes it was, you know, a pre surgery evaluation or it was a tinnitus management or it was just an annual hearing tests just monitoring for somebody who’s on chemotherapy or something totally right. So hearing aids were becoming less of a priority to me and they still obviously were a big part of what I did but I wasn’t really acquittee everything and hearing aid sales so I started to already feel like I need to diversify because what if you know then it was like oh, my god OTC is coming like this big scary thing right? Like we didn’t know when it was gonna come but we knew it was coming at some point. I’m thinking I’m gonna diversify because what if hearing aids are just like over the counter and Amani Internet, and right and whatever. I know how to do a lot. So let’s start doing it. So the next slide, I’m going to add balance Tuesday. Okay, so I got a spec 2016 I think so at

Dave Kemp  33:44

the time you were assent. Audiology was just a set audiology.

Ali Vega, Au.D.  33:47

Yeah. Okay. They said audiology and hearing. Yeah. Okay. And so I decided that I’m going to do balance and I went to an ATA conference. And I did want to Richard ganz AIB seminars like a pre conference seminar things we did today thing. And I was so mean, Dr. Ganz really has this dialed in. Yeah, so I got super excited. Okay, now I can diversify and legitimize my business, not just the girl who does hearing tests, the girl who sells hearing aids, but now I’m like, a real audiologist, right? So I go through that whole class, and I get really excited. And I do some interviews with Dr. Dan’s. He’s like, Yeah, let’s do it. And then he tells me how much it’s gonna cost. I’m like, that’s not really my pitch. And he was like, No, you got to see like, you’re gonna make all this money. It’ll be and I just couldn’t to me. I had a lot of sticker shock. So then I did, and I made another mistake, but I learned a lesson. I was like, how about I just buy the equipment myself? Let’s do it. Like, how hard can that be? School? Well, I had to remember that when I went to school, they were en G’s and you You put water in people’s ears, and then you got this big long tape of their nystagmus, you had to get a ruler out and you had to like measure their eye movement and do a bunch of math. And it was not, it was not great. So I thought, well, I’ll just buy some equipment, and I’ll just do it. So I did that and hated it. Number one, number two, I couldn’t figure out how to make a business out of it. And so then I bought a pigment and it wasn’t using it. I didn’t know how to get patients, I didn’t know enough market it, I didn’t know how to do anything. And that was a big waste of money. So a couple years later, I went back to Dr. Dan’s and says, my tail between my legs. Okay, so I bought this equipment. And now I need your help. And he was like, well, that equipment is awful. But that’s fine. You know, so he’s done some really great coaching with me. I was like, Okay, it’s what you have, we’ll make We’ll make it work. So I joined AIB, and like, the 2019, I think, yeah, I think it was that 1819, something like that, and helped me really get my balance program going. And so now we do a lot of piston dealer, we’ve got now we’ve got the two rotary chairs. And we’ve got all this really great equipment. I’m not doing it myself, which is another great thing I hired an audiologist to do it. So that’s been like the next phase of my businesses. So I break away from a scent, and trying to now diversify my services, I want to be really a full scope, audiology practice. Yep. And first thing I did was add clients, and then entering AIB and really, really happy really successful with that program. And it’s not cheap. But I’ll tell you what, it is great to have people who are really good at what they do mentoring you. And again, like getting a bookkeeper and accountant and lawyer and although in a billing person working with Addy has been in that same pocket for me, because I don’t really love vestibular. So I mean, there is a need and to help me.

Dave Kemp  36:57

So you mentioned, you know, okay, because of these relationships you have with the physicians, you’re getting a lot of diagnostic referrals and stuff like that. So now, like, you know, kind of, once you had properly I guess, is the right way to put it been on boarded or had a balance offering that you felt comfortable standing beside and like you kind of had an idea of how you were gonna monetize it and all that. What was that period, like, in terms of when you started to see that part of your business kind of come online? Was it? This is catering to your existing patient base? Or was this like opening the door to an entirely new set of patients? Just kind of like, give me give me a sense of what that what that like unlocked for your business by becoming a Balance Center as well?

Ali Vega, Au.D.  37:47

Yeah, so when I bought the equipment, tried to do it myself, I was gonna is really this, the e and t at the hospital who lived in my neighborhood. And I was like, Okay, I’m do balance. He’s like, great, because I don’t want to do balance. So he didn’t want to see peace patients at all. So he was happy to send them to me, but honestly, he was sending me like, three a month. Okay, because he because he didn’t want Dizzy patients either. So they really weren’t coming to him. He was my main referral source. And it couldn’t really find anybody in town who had Dizzy patients. So when I started working with Dr. Ganz, they really helped me understand how to market this and how to get those. And what we’re finding is we’re getting them from our existing database or anything. Interest in radio, radio, that’s one of my top commercials, is talking about dizziness. Because you know what? Everybody has dizziness. I know where everybody knows somebody who has dizziness, right? And we get on the radio, we talk about dizziness, and people are out of control. Calling us or talking to one I mean, the people the radio station want to talk to us. It’s everybody wants to talk about dizziness. It’s right up there with earwax removal. Everybody has to unclad our wax stuff mantasy. Next. That’s, and now what I’m finding now is that we’re so we’ve been doing this for a few years. And so we’re always asking, and when we do a case history with a new patient, you were always asking those vestibular questions. And if they’re like, oh, yeah, I do have balance problems. We’re like, okay, and then after today, we’re gonna get you set up for vestibular evaluation, like we just make that. Okay, that’s next steps, because you’ve already identified these concerns. And we think that we need to evaluate that. And so that’s built in now to our initial evaluation, but we scheduled for a different day. But then also on Friday got this hearing aid patients that I’ve had for decades. Well, yeah, they’ll come in and they come in for a hearing aid follow up or something. You’re like, Hey, I see that you guys do balance now eat? Have I ever told you that I’m dizzy, like, oh my gosh, we never talked about that. And that. I think I should have a balance just like yeah, you show it. So I mean, it’s really there’s so many people in my existing database that are vestibular evaluation candidates,

Dave Kemp  39:49

which I think has to be even more of a testament to why it’s just really interesting that like hearing you talk through your thought process and your decision making around on why you even wanted to get into vestibular sort of like this feeling that you kind of need to diversify your services. But I feel like you know, when you’re making that decision, if you do own a practice, or you’re considering maybe building a practice, you know, in your thinking through what kinds of services you’re going to offer, I feel like that’s super reassuring to know that look, you’re not going to have to, like reinvent the wheel, if you will, with go after all kinds of totally different kinds of patient base or something like that. The A lot of these patients are actually just your existing patients. That’s yeah, that’s actually comforting. I would think that you’ve, you’ve got, quote, unquote, low hanging fruit right there.

Ali Vega, Au.D.  40:35

Totally. Absolutely. And it brings in a lot of times, the younger demographic of people, which is great, too. So it it just by advertising the dizziness. Now we’ve we’ve opened ourselves up, because now it’s not just for old people, right? Like, you can be any age Desi totally. But yeah, it was it was not difficult to find Dizzy patients.

Dave Kemp  40:56

And so I should thank you for even taking the time to do this. Because I know you’re in the heart of expanding from one clinic to three right now, which I feel like is kind of the next chapter. So do you want to talk about what this process has been like? And what, what’s the backstory there? How did this even come to be? You know, for this this chapter?

Ali Vega, Au.D.  41:17

Sure. Yeah. Well, Adrian. So you know, like I said, I had, I had two other satellite offices. So I ended up closing the office at the hospital. Because again, once they realized how well I was doing, they wanted to change the financial relationship. And I said, I don’t actually need this. Anything as in still in that hospital system is the referral source for hearing even though I no longer have a satellite office there, but I’m less than a mile away. So it makes it an easy, easy choice. So I have a great relationship with those, those EMTs. So they refer to us a lot. We refer to them. And it’s it’s great. But after the pandemic, I’m sure almost every audiologist can agree with. It was like people came out of the woodwork. Once masks went on people’s faces, all of a sudden a hearing loss that was not a problem is now a serious problem. Totally. Right. And so it was like our business, I didn’t even have to try. And our business was like quadrupled. Wow. And, and so and I always knew that I did want to try another location just because it was the geographic area of where Olympia is. We’re rural. But we’re also at the state capitol. And people, there’s a lot of these pockets, these rural pockets where people don’t have services. And they don’t want to come in to Seattle, they want they don’t want to go into Tacoma, they don’t want to come into Olympia. And so I knew that if I took health care to them, I would be successful out there. And so I’ve been kind of looking at some different areas. But I was looking at Lacey Washington, which is a suburb of Olympia, it’s only 20 miles away from my other office. But I’ll swear to you people don’t go from one to Olympia to Lacey on day unless they have to. So I picked a spot that was close to the end practice that I left in 2011. And there’s a new multi care hospital coming in. But there’s a lot of medical, there’s a lot of medical right here and there was no audit while there’s there are a couple other audiologists. But really, it was pretty untapped market. And so my husband and I knew that we didn’t want to rent we wanted to buy we found a commercial building in a good location for a good price. And so we just like, without really thinking about it. We just bought it. It was like, Okay, I guess I’m starting a clinic in Lacey Washington. And so we started renovating it. And that was like June of last year. And we’re getting that kind of put together. And then a colleague of mine called me and he had a clinic 30 miles south of Olympia, and she hatless Washington, and he said, I need to retire. Will you buy my practice for me? And I was like, oh, man, no. And he’s like, come on, you got to practice. You got all these audiologists working for you. He’s like, come on. So I said, Okay, I’ll do it. So I ended up buying his practice in August, I was already working on this second location. So I had like two practices opening at the same time, it was not planned. I wouldn’t recommend it. It’s a lot. But these are two areas that were untapped, and really need help. And so my plan was okay, so we’ll just do like a soft opening. So for the lease the office, things got delayed with construction just for supply chain issues, and labor issues and things like that. So we didn’t actually open until January, but I was like, Okay, let’s just plan one day a week. I’ll do it because I need to make sure that I’ve got everything set up the way I want before I serve pluggy and other employees there. And so we opened up just Tuesdays and first Tuesday filled up, like, overnight, and then the next Tuesday was filled up and next thing you know, we’re three weeks, all of January it was booked with it like before, I think before I even saw patient maybe it was that first week I’ve seen patients because people were like, Oh my God, oh yeah, we want we want this location open. So then we’re like, oh, I guess we should open it a second day a week. So we opened up a Thursday those are full and then I was here the other day, and patients were just stopping in. We weren’t open for appointments. I was like in a sweatshirt and jeans, I was cleaning, I was unpacking and trying to get moved in. And people are walking in, Hey, can I buy batteries? Hey, can I get filters? Hey, can you clean my hearing aids? I was like, well, we’re not actually open. Oh, I thought this location was open. So we know is to start staffing at full time. And we’ve got providers coming here three days a week. I think we’ll be five days a week by March. Wow. Because what the demand is there, I don’t personally like to have schedules booked more than two weeks out. I don’t want patients to have to wait more than two weeks. So that’s that’s kind of my standard when I’m looking to see when do we add another day? When do we add a meta provider there? It’s Are we more than two weeks out? And if patients can get it within two weeks, that’s probably okay. But at this point, we’re booked out. So we’re going to be open for these days. And then the show hatless location, you know, I bought an existing practice. So we just thought, well, we’ll just keep his schedule, he was just going Thursday, so he was just doing one day a week. And those were say things filling up filling up. And the space he was in wasn’t really conducive to the way that we practice because we, we do so much more, and we have more equipment and things like that. So we ended up moving to a new location. And that’s open three days a week now and we’re gonna probably be five days a week here pretty soon. I have to hire more doctors. That’s what has to happen.

Dave Kemp  46:21

good segue, I was gonna ask you a how many people do you employ now? And then maybe we can start talking a little bit about your? Because that seems like another really big challenge is how do you find talent? In what appears to be a bit of a labor shortage? I mean, nationally speaking, but in this industry as well. So how many people do you currently employ?

Ali Vega, Au.D.  46:43

So including myself, we have five audiologist,

Dave Kemp  46:45

five audiologist? And do you have any assistance or anything like that? Yeah,

Ali Vega, Au.D.  46:50

so I have 14 employees total. So and what we do is we hire front office staff first, and then we promote from within. So during that 90 Day probationary period, we’re assessing skills, we’re checking in with them. What do you like about this job, because usually, nobody’s ever heard of audiology and don’t even know what an audiology assistant is, it’s hard to hire for that position. So we hire front office, people who have an interest in medicine or an interest in customer service, they should care. And so we’ve got three audiology assistants, right now that we’ve promoted from front desks. And that’s awesome. And that’s how we do it. Because sometimes we’ll get in here and they’re like, I really liked the billing part of it, we really like the data entry. And so we put them more on like, assisting our billing company with collecting information or doing AR reports and things like that. And then other people are like, I really like helping patients. So we teach them how to clean and check hearing aids and send them through some some online training to learn how to be an audiology assistant. So it’s definitely a work in progress. But we’re always on always hiring because we’re growing.

Dave Kemp  47:59

So where are you finding new people?

Ali Vega, Au.D.  48:03

Well, audiologists we’re, I’m hiring a lot of new grads. And I like new grads, because they’re passionate, they’re excited. They know all the new stuff. Like I went to school a long time ago. What I knew their lab dated there. They were they they’re up on all the current standards of everything. So so they’ve got that edge to them. But they’re also open to being trained, they’ve just come out of their fourth year rotation. And they’re, they’re used to being mentored and learning new ways of doing things. And they’ve learned things that maybe we don’t know about, and they can bring in some new fresh ideas to our business as well. So we’ve, we’ve done that we’ve taken fourth years, we haven’t had any fourth year stay with us, but we do continually take students and then we get students who have just completed, we actually have a pretty good relationship with the Seattle VA, and we’re gonna get some of their top X turns

Dave Kemp  49:03

Awesome. How did you fall in that relationship?

Ali Vega, Au.D.  49:07

One of my audiologists actually works for the VA on the weekends as a contractor, and so she has an in with them. And also, we get the cream of the crop. Very nice, nice relationship.

Dave Kemp  49:19

Did you have a hard time hiring the five audiologists that you employ? I guess you’re kind of near Seattle, which is such a big city that it might be easier for you then maybe someone that’s not as close to a big metro like that.

Ali Vega, Au.D.  49:33

Yeah, I mean, I think I think when I hire audiologist, the the pole is living the Pacific Northwest. This is a very interesting place for for people to live, especially people who’ve maybe lived in, you know, on the other side of the country that come to the Pacific Northwest. It’s like oh my gosh, it’s so different and but it’s it’s hard to find people to come to Olympia. So we’re in our salaries

Dave Kemp  49:59

Seattle. Already the place that’s three miles south,

Ali Vega, Au.D.  50:02

that is shameless. Yeah. I mean, that’s a much more rural area. So it’s hard to get people to want to come here. And you can’t live in Seattle and drive down. You just can’t. You can live here, and then drive to Seattle on the weekends. That’s a really easy thing to do. But the commuting is anywhere. We’d got traffic, like California’s got traffic at this point. So commuting is not really an option. So that I would say that’s the hardest part is getting people to want to land in this smaller community, who maybe are drawn to Seattle. We’re

Dave Kemp  50:31

not Seattle. Yeah. Okay. That’s very interesting. So what does? By the way, this has just been awesome. I’ve really enjoyed the story. And it’s, this has been a great conversation. What does the future hold for you? Like what, clearly this year, you’re very focused on getting these clinics up and running. But we were kind of joking at the beginning, before we started recording that you had just recently like gone to your therapist, and that you’re like, asking the question of when is enough enough? Like, do you want to keep expanding? What’s is the motivation here that like, I just can’t help myself, because this is so fun.

Ali Vega, Au.D.  51:09

Yes, this is so fun. And that’s the problem I’m having is that I enjoy doing this so much that I hurt, I don’t want to stop. But I realize at some point, I’m going to have to just say, I’m going to let other people take over from our or let them have that opportunity. But I’m an opportunist. So when I see the opportunity, and I know that we do it better, I just know that we’re bringing the type of audiology to people, that is an the top, I just, I want to I want to keep doing it. So what’s on the horizon right now, as I do have one work clinic, my husband’s a contractor. And so we have purchased property in another community. And he’s gonna He’s in the permitting process, and he’s going to build the building. And so we’re going to be out there. And so you’ll met our clinics, I’ll have four clinics, and I think I need to stop that. See, I need to stop and at that point, but then I’m always like, like, what’s another opportunity came up for you know, so I don’t know. Yeah, that’s cool. But I need to hire more more audiologists. Because right now we’re all rotating through all the clinics. And we just we need, there needs to be more of us to go around. We’re spread a little thin right now. Yeah,

Dave Kemp  52:19

I couldn’t. Yeah, that’s totally true. There’s just only so many audiologists out there. So as we kind of come to the close here, I, you know, for anybody that might be interested in connecting with you, and, you know, maybe asking questions about where they would go in terms of how to build a business like you did? I mean, it seems like you’ve had so much experience in you have so much wisdom around what to avoid? What’s the best way people can connect with you, email? Are you on social media? I don’t know.

Ali Vega, Au.D.  52:53

Yeah. And so emails, great. They, I have Facebook and Instagram, I’m on LinkedIn, but I, there’s only so many hours in the day. So So or you can text me call me. You know, I get asked a lot for people who were like, like this contact I have through AB because I do cochlear implants as well. And she sent me a message through Facebook, I think the other day, she was like, Hey, I know somebody who wants to add cochlear implants to their private practice, would you be willing and like, for sure, I’m always happy to share my my story or to listen to somebody else going, you know, what do you think? Because I’ve had people do that. For me, that’s been one of my success paths is that I’ve had great mentors, I’ve had people that you can think I can think of like 10 Off the top of my head right now, people who were ahead of me in this profession, who would listen to me I’d come to them, like, we thought this crazy idea and maybe not now or if that’s not obvious, but we thought that through ally, or people have been like, Yeah, that’s amazing. That’s such a great idea. You should totally do that. I’m like, okay, but that’s that’s what it takes, I think in this audiology profession, because we don’t have a lot of mentoring. I don’t think at this point in times, and you got to kind of go out and find your mentors. You had a friend to the league click with, I have found that people really at conferences have slipped by called in my audiology friends, but I have some of my best friends or people I’ve seen once a year at a conference.

Dave Kemp  54:23

Yeah. Well, I’m glad that you said that though. Because I’ve been. This has been a reoccurring theme. And something I’ve noticed too, is it is a little bit like I think there’s an opportunity for somebody to create like a true mentor program in this industry, because there is seemingly kind of a gap there. But I think I agree with you that I think one of the best ways for anyone to establish a network and find like minded people that can if nothing else, be another sounding board that you can bounce ideas off of. Trade Shows are an excellent way to do that. Whether it’s just go to AAA or ADA you know, the Big ones or your stage show. But I couldn’t agree more with that, that I think that’s a great way to it, especially as a young person, if you’re just getting started out, that’s a really efficient way to meet a lot of people at once.

Ali Vega, Au.D.  55:13

Absolutely, it’s, and it’s a great way to get out of the climate of classes are one component of it, the CES, yeah, we all need those met, those are really important. But stay after for the networking events, get involved, you know, volunteer for the organization, or join the pack, or just go to at least the happy hour stuff, find people that are interested in audiology, the same as you, you’ll have similar interests. I’ve had some very awkward conversations that have turned out to be you know, really impactful for behavioral meeting summer, you sit down to have breakfast, and some random person starts talking to you. Next thing, you know, you’ve got these connections, or you’re like, Hey, you, you know something that I’ve actually been really needing to learn about, you exchange business cards, and it can be a game changer for your career, you just never know, again, now, you got to put yourself out there, you got to just show up and see what happens and be available for opportunity. Say, Yes,

Dave Kemp  56:10

I agree. And you figure it out. It’s like, you’re, it’s unavoidable. It’s going to be uncomfortable, it’s gonna be awkward, you’re gonna have to make small talk with people that you don’t know. But I totally agree that just, you’ll be amazed at how much you have in common with some of these other people. And I think that there’s so much truth, you’re a testament to it of like just being out there and giving yourself more opportunities for like, as random as they might seem things to follow your follow your way, I think is just super important to establish yourself and your connections.

Ali Vega, Au.D.  56:48

Yeah, absolutely. And we don’t need to be competitive, that there’s, there’s no room for that. I don’t think, because there’s so many people that need our help. And we’re only better if we share information with each other. And like, you know, hey, I developed this thing, and I let me email it to you like I love it when I go to a class and they’re like, hey, email me and I’ll send you all my notes or you can talk to me. That’s, that’s the best way for us to get better and to and to be really at the top of our game.

Dave Kemp  57:15

And on that note, thank you so much for being super transparent today and talking. So candidly about your your story, your business. I loved it. I really appreciate you coming on. This has been a lot of fun.

Ali Vega, Au.D.  57:29

I’ve had so much fun. I really enjoyed telling you my story. It’s a crazy story. So thanks for being interested as

Dave Kemp  57:34

I’m ready for your to read your book when you go and publish it. It’s not done yet. So you can’t write it yet. But you know, it’s a work in progress. But, but thank you so much and thanks for everybody who tuned in here to the end. We’ll chat with you next time. Cheers.

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